Assembly Bill No. 550–Committee on Judiciary

 

CHAPTER..........

 

AN ACT relating to health; making various changes to procedures for the detention and civil commitment of mentally ill persons; expanding the rights of patients of certain health care facilities; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. NRS 433A.150 is hereby amended to read as follows:

1-2    433A.150  1.  Any person alleged to be a mentally ill person may ,

1-3   upon application pursuant to NRS 433A.160 and subject to the

1-4   provisions of subsection 2, be detained in a public or private mental health

1-5   facility or hospital under an emergency admission for evaluation,

1-6   observation and treatment . [subject to subsection 2.]

1-7    2.  Except as otherwise provided in subsection 3, a person admitted to a

1-8   mental health facility or hospital under subsection 1 must [not be detained

1-9   in excess of] be released within 72 hours, including [Saturdays and

1-10   Sundays,] weekends and holidays, from the time of his admission unless

1-11   within that period a written petition for an involuntary court-ordered

1-12   admission [has been] is filed with the clerk of the district court pursuant to

1-13   NRS 433A.200 [.] , including, without limitation, the documents

1-14   required pursuant to NRS 433A.210, or the status of the person is

1-15   changed to a voluntary admission.

1-16    3.  If the [72-hour] period specified in subsection 2 expires on a day on

1-17   which the office of the clerk of the district court is not open, the written

1-18   petition must be filed [on or before the close of the business day next

1-19   preceding the expiration of that period, except that, if that business day is

1-20   the same day as that upon which the person was admitted, the petition

1-21   must be filed] on or before the close of the business day next following the

1-22   expiration of that period.

1-23    Sec. 2.  NRS 433A.160 is hereby amended to read as follows:

1-24    433A.160  1.  [Application for an] Except as otherwise provided in

1-25   subsection 2, an application for the emergency admission of an allegedly

1-26   mentally ill person for evaluation , [and] observation and treatment may

1-27   only be made by an accredited agent of the department, an officer

1-28   authorized to make arrests in the State of Nevada or a physician,

1-29   psychologist, marriage and family therapist, social worker or registered

1-30   nurse. The agent, officer, physician, psychologist, marriage and family

1-31   therapist, social worker or registered nurse may [take] :

1-32    (a) Without a warrant:

1-33      (1) Take an allegedly mentally ill person into custody [without a

1-34   warrant] to apply for the emergency admission of the person for

1-35   evaluation, observation and treatment [under 433A.150 and may:

1-36    (a)] ; and

1-37      (2) Transport the allegedly mentally ill person [; or

1-38    (b) Arrange] to a public or private mental health facility or hospital for

1-39   that purpose, or arrange for the person to be transported by:

1-40      [(1)] (I) A local law enforcement agency;


2-1       [(2)] (II) A system for the nonemergency medical transportation of

2-2  persons whose operation is authorized by the transportation services

2-3   authority; or

2-4       [(3)] (III) If medically necessary, an ambulance service that holds

2-5  a permit issued pursuant to the provisions of chapter 450B of

2-6  NRS . [,

2-7  to a public or private mental health facility for that purpose.] only if the

2-8   agent, officer, physician, psychologist, marriage and family therapist,

2-9   social worker or registered nurse has, based upon his personal

2-10   observation of the allegedly mentally ill person, probable cause to believe

2-11   that the person is a mentally ill person and, because of that illness, is

2-12   likely to harm himself or others if allowed his liberty.

2-13    (b) Apply to a district court for an order requiring:

2-14      (1) Any peace officer to take an allegedly mentally ill person into

2-15   custody to allow the applicant for the order to apply for the emergency

2-16   admission of the allegedly mentally ill person for evaluation, observation

2-17   and treatment; and

2-18      (2) Any agency, system or service described in subparagraph (2) of

2-19   paragraph (a) to transport the allegedly mentally ill person to a public or

2-20   private mental health facility or hospital for that purpose.

2-21  The district court may issue such an order only if it is satisfied that there

2-22   is probable cause to believe that the allegedly mentally ill person is a

2-23   mentally ill person and, because of that illness is likely to harm himself

2-24   or others if allowed his liberty.

2-25    2.  An application for the emergency admission of an allegedly

2-26   mentally ill person for evaluation, observation and treatment may be

2-27   made by a spouse, parent, adult child or legal guardian of the person.

2-28   The spouse, parent, adult child or legal guardian and any other person

2-29   who has a legitimate interest in the allegedly mentally ill person may

2-30   apply to a district court for an order described in paragraph (b) of

2-31   subsection 1.

2-32    3.  The application for the emergency admission of an allegedly

2-33   mentally ill person for evaluation, observation and treatment must reveal

2-34   the circumstances under which the person was taken into custody and the

2-35   reasons therefor.

2-36    [3.] 4. As used in subsection 1, “an accredited agent of the

2-37   department” means any person appointed or designated by the director of

2-38   the department to take into custody and transport to a mental health

2-39   facility pursuant to subsections 1 and 2 those persons in need of

2-40   emergency admission.

2-41    [4.  Any person who has reason to believe that another person is

2-42   mentally ill may apply to the district attorney of the county where the

2-43   allegedly mentally ill person is found, and the district attorney may, if

2-44   satisfied that as a result of mental illness the person is likely to harm

2-45   himself or others:

2-46    (a) Issue an order to any peace officer for the immediate apprehension

2-47   of the person and his transportation to a public or private mental health

2-48   facility; and

2-49    (b) Apply for the admission of the person under the emergency

2-50   admission provisions of NRS 433A.150.]


3-1    5.  Except as otherwise provided in this subsection, each person

3-2  admitted to a public or private mental health facility or hospital under an

3-3   emergency admission must be evaluated at the time of admission by a

3-4   psychiatrist or a psychologist. If a psychiatrist or a psychologist is not

3-5   available to conduct an evaluation at the time of admission, a physician

3-6   may conduct the evaluation. Each such emergency admission must be

3-7   approved by a psychiatrist.

3-8    Sec. 3.  NRS 433A.170 is hereby amended to read as follows:

3-9    433A.170  Except as otherwise provided in this section, the

3-10   administrative officer of a facility operated by the division or of any other

3-11   public or private mental health facility or hospital shall not accept an

3-12   application for an emergency admission under NRS [433A.150 and]

3-13   433A.160 unless that application is accompanied by a certificate of a

3-14   psychiatrist or a licensed psychologist stating that he has examined the

3-15   person alleged to be mentally ill and that he has concluded that [as a result

3-16   of mental illness] the person is a mentally ill person and, because of that

3-17   illness is likely to harm himself or others[.] if allowed his liberty. If a

3-18   psychiatrist or licensed psychologist is not available to conduct an

3-19   examination, a physician may conduct the examination. The certificate

3-20   required by this section may be obtained from a psychiatrist, licensed

3-21   psychologist or physician who is employed by the public or private mental

3-22   health facility or hospital to which the application is made.

3-23    Sec. 4.  NRS 433A.200 is hereby amended to read as follows:

3-24    433A.200  1.  A proceeding for an involuntary court-ordered

3-25   admission of any person in the State of Nevada may be commenced by the

3-26   filing of a petition with the clerk of the district court of the county where

3-27   the person who is to be treated resides. The petition may be filed by the

3-28   spouse, parent, adult children or legal guardian of the person to be treated

3-29   or by any physician, psychologist, social worker or registered nurse, by an

3-30   accredited agent of the department or by any officer authorized to make

3-31   arrests in the State of Nevada. The petition must be accompanied:

3-32    (a) By a certificate of a physician , psychiatrist or licensed psychologist

3-33   stating that he has examined the person alleged to be mentally ill and has

3-34   concluded that [as a result of mental illness] the person is a mentally ill

3-35   person and, because of that illness is likely to harm himself or others[;]

3-36   if allowed his liberty; or

3-37    (b) By a sworn written statement by the petitioner that:

3-38      (1) The petitioner has, based upon his personal observation of the

3-39   person alleged to be mentally ill, probable cause to believe that the person

3-40   is a mentally ill person and, because of that illness is likely to harm

3-41   himself or others[;] if allowed his liberty; and

3-42      (2) The person alleged to be mentally ill has refused to submit to

3-43   examination or treatment by a physician, psychiatrist or licensed

3-44   psychologist.

3-45    2.  If the person to be treated is a minor and the petitioner is a person

3-46   other than a parent or guardian of the minor, the petition must, in addition

3-47   to the certificate or statement required by subsection 1, include a statement

3-48   signed by a parent or guardian of the minor that the parent or guardian

3-49   does not object to the filing of the petition.


4-1    Sec. 5.  NRS 433A.210 is hereby amended to read as follows:

4-2    433A.210  [A] In addition to the requirements of NRS 433A.200, a

4-3   petition filed pursuant to that section with the clerk of the district court to

4-4   commence proceedings for involuntary court-ordered admission of a

4-5   person pursuant to NRS 433A.145 or 433A.150 must include[:

4-6    1.  A] a certified copy of [the] :

4-7    1.  The application for the emergency admission of the person made

4-8   pursuant to NRS 433A.160 [with respect to the person detained;] ; and

4-9    2.  A petition executed by a psychiatrist, licensed psychologist or

4-10   physician [certifying that he] , including, without limitation, a sworn

4-11   statement that:

4-12    (a) He has examined the person alleged to be mentally ill [and has

4-13   concluded that as a result of mental illness the person is likely to harm

4-14   himself or others; and

4-15    3.  If the person to be treated is a minor and the petitioner is a person

4-16   other than a parent or guardian of the minor, a statement signed by a

4-17   parent or guardian of the minor that the parent or guardian does not object

4-18   to the filing of the petition.] ;

4-19    (b) In his opinion, there is a reasonable degree of certainty that the

4-20   person alleged to be mentally ill suffers from a mental illness;

4-21    (c) Based on his personal observation of the person alleged to be

4-22   mentally ill and other facts set forth in the petition, the person poses a

4-23   risk of imminent harm to himself or others; and

4-24    (d) In his opinion, involuntary admission of the person alleged to be

4-25   mentally ill to a mental health facility or hospital is medically necessary

4-26   to prevent the person from harming himself or others.

4-27    Sec. 6.  NRS 433A.220 is hereby amended to read as follows:

4-28    433A.220  1.  Immediately after he receives any petition filed

4-29   pursuant to NRS 433A.200 or 433A.210, the clerk of the district court

4-30   shall transmit the petition to the appropriate district judge, who shall set a

4-31   time, date and place for its hearing. The date must be [:

4-32    (a) Within 14 calendar days after the date on which the petition is

4-33   received by the clerk;

4-34    (b) If at the time the petition is received by the clerk the subject of the

4-35   petition was admitted to a hospital or public or private mental health

4-36   facility pursuant to NRS 433A.160, within 5 judicial days after the date on

4-37   which the petition is received by the clerk; or

4-38    (c) If the district attorney filed a petition for the emergency admission

4-39   of the subject of the petition,] within 5 judicial days after the date on

4-40   which the petition is received by the clerk.

4-41    2.  The court shall give notice of the petition and of the time, date and

4-42   place of any proceedings thereon to the subject of the petition, his

4-43   attorney, if known, the petitioner, the district attorney of the county in

4-44   which the court has its principal office, the local office of an agency or

4-45   organization that receives money from the Federal Government pursuant

4-46   to 42 U.S.C. §§ 10801 et seq., to protect and advocate the rights of

4-47   mentally ill persons [with mental illnesses] and the administrative office

4-48   of any public or private mental health facility in which the subject of the

4-49   petition is detained.


5-1    3.  The provisions of this section do not preclude a facility from

5-2  discharging a person before the time set pursuant to this section for the

5-3   hearing concerning the person, if appropriate.

5-4    Sec. 7.  NRS 433A.240 is hereby amended to read as follows:

5-5    433A.240  1.  After the filing of a petition to commence proceedings

5-6   for the involuntary court-ordered admission of a person pursuant to NRS

5-7   433A.200or 433A.210, the court shall promptly cause two or more

5-8   physicians or licensed psychologists, one of whom must always be a

5-9   physician, to examine the person alleged to be mentally ill, or request an

5-10   evaluation by an evaluation team from the division of the person alleged to

5-11   be mentally ill.

5-12    2.  To conduct the examination of a person who is not being detained

5-13   at a mental health facility or hospital under emergency admission pursuant

5-14   to an application made pursuant to NRS [433A.150,] 433A.160, the court

5-15   may order a peace officer to take the person into protective custody and

5-16   transport him to a mental health facility or hospital where he may be

5-17   detained until a hearing is had upon the petition.

5-18    3.  [Unless] If the person is [admitted] not being detained under an

5-19   emergency admission pursuant to an application made pursuant to NRS

5-20   [433A.150,] 433A.160, he may be allowed to remain in his home or other

5-21   place of residence pending an ordered examination or examinations and to

5-22   return to his home or other place of residence upon completion of the

5-23   examination or examinations. The person may be accompanied by one or

5-24   more of his relations or friends to the place of examination.

5-25    4.  Except as otherwise provided in this subsection, each physician and

5-26   licensed psychologist who examines a person pursuant to subsection 1

5-27   shall, not later than 48 hours before the hearing set pursuant to NRS

5-28   433A.220, submit to the court in writing a summary of his findings and

5-29   evaluation regarding the person alleged to be mentally ill. If the person

5-30   alleged to be mentally ill is admitted under an emergency admission

5-31   pursuant to an application made pursuant to NRS [433A.150,] 433A.160,

5-32   the written findings and evaluation must be submitted to the court not later

5-33   than 24 hours before the hearing set pursuant to [paragraph (b) of]

5-34   subsection 1 of NRS 433A.220.

5-35    Sec. 8.  NRS 433A.270 is hereby amended to read as follows:

5-36    433A.270  1.  The allegedly mentally ill person or any relative or

5-37   friend on his behalf is entitled to retain counsel to represent him in any

5-38   proceeding before the district court relating to involuntary court-ordered

5-39   admission, and if he fails or refuses to obtain counsel, the court shall

5-40   advise him and his guardian or next of kin, if known, of such right to

5-41   counsel and shall appoint counsel, who may be the public defender or his

5-42   deputy.

5-43    2.  Any counsel appointed pursuant to subsection 1 [shall] must be

5-44   awarded compensation by the court for his services in an amount

5-45   determined by it to be fair and reasonable. The compensation [shall] must

5-46   be charged against the estate of the person for whom the counsel was

5-47   appointed[,] or , if the person is indigent, [the compensation shall be

5-48   charged] against the county where the allegedly mentally ill person last

5-49   resided.

5-50    3.  The court shall, at the request of [any counsel,] counsel

5-51   representing the allegedly mentally ill person in proceedings before the


6-1  court relating to involuntary court-ordered admission, grant a recess in

6-2  the proceedings for the shortest time possible, but for not more than 5

6-3  days , to give the counsel an opportunity to prepare his case.

6-4    4.  Each district attorney or his deputy shall appear and represent the

6-5   state in all involuntary court-ordered admission proceedings in his county.

6-6   The district attorney is responsible for the presentation of evidence, if any,

6-7   in support of the involuntary court-ordered admission of a person to a

6-8   mental health facility in proceedings held pursuant to NRS 433A.200 or

6-9   433A.210.

6-10    Sec. 9.  NRS 433A.310 is hereby amended to read as follows:

6-11    433A.310  1.  If the district court finds, after proceedings for the

6-12   involuntary court-ordered admission of a person to a public or private

6-13   mental health facility:

6-14    (a) That there is not clear and convincing evidence that the person with

6-15   respect to whom the hearing was held is a mentally ill person or exhibits

6-16   observable behavior such that he is likely to harm himself or others if

6-17   allowed [to remain at] his liberty, the court shall enter its finding to that

6-18   effect and the person must not be involuntarily detained in such a facility.

6-19    (b) That there is clear and convincing evidence that the person with

6-20   respect to whom the hearing was held is a mentally ill person and, because

6-21   of that illness, is likely to harm himself or others if allowed [to remain at]

6-22   his liberty, the court may order the involuntary admission of the person for

6-23   the most appropriate course of treatment. The order of the court must be

6-24   interlocutory and must not become final if, within 30 days after the

6-25   involuntary admission, the person is unconditionally released pursuant to

6-26   NRS 433A.390.

6-27    2.  An involuntary admission pursuant to paragraph (b) of subsection 1

6-28   automatically expires at the end of 6 months if not terminated previously

6-29   by the medical director of the public or private mental health facility as

6-30   provided for in subsection 2 of NRS 433A.390. At the end of the court

6-31  -ordered period of treatment, the division or any [nondivision] mental

6-32   health facility that is not operated by the division may petition to renew

6-33   the detention of the person for additional periods not to exceed 6 months

6-34   each. For each renewal, the petition must set forth to the court specific

6-35   reasons why further treatment would be in the person’s own best interests.

6-36    3.  Before issuing an order for involuntary admission or a renewal

6-37   thereof, the court shall explore other alternative courses of treatment

6-38   within the least restrictive appropriate environment as suggested by the

6-39   evaluation team who evaluated the person, or other persons professionally

6-40   qualified in the field of psychiatric mental health, which the court believes

6-41   may be in the best interests of the person.

6-42    Sec. 10.  NRS 433A.370 is hereby amended to read as follows:

6-43    433A.370  1.  When a client committed by a court to a division

6-44   facility on or before June 30, 1975, or a client who is judicially admitted

6-45   on or after July 1, 1975, or a person who is involuntarily detained pursuant

6-46   to NRS [433A.150] 433A.145 to 433A.300, inclusive, escapes from any

6-47   division facility, or when a judicially admitted client has not returned to a

6-48   division facility from conditional release after the administrative officer of

6-49   the facility has ordered him to do so, any peace officer shall, upon written

6-50   request of the administrative officer or his designee and without the


7-1  necessity of a warrant or court order, apprehend, take into custody and

7-2  deliver the person to such division facility or another state facility.

7-3    2.  Any person appointed or designated by the director of the

7-4   department to take into custody and transport to a division facility persons

7-5   who have escaped or failed to return as described in subsection 1 may

7-6   participate in the apprehension and delivery of any such person, but may

7-7   not take the person into custody without a warrant.

7-8    Sec. 11.  NRS 449.710 is hereby amended to read as follows:

7-9    449.710  Every patient of a medical facility, facility for the dependent

7-10   or home for individual residential care has the right to:

7-11    1.  Receive information concerning any other medical or educational

7-12   facility or facility for the dependent associated with the facility at which

7-13   he is a patient which relates to his care.

7-14    2.  Obtain information concerning the professional qualifications or

7-15   associations of the persons who are treating him.

7-16    3.  Receive the name of the person responsible for coordinating his care

7-17   in the facility or home.

7-18    4.  Be advised if the facility in which he is a patient proposes to

7-19   perform experiments on patients which affect his own care or treatment.

7-20    5.  Receive from his physician a complete and current description of his

7-21   diagnosis, plan for treatment and prognosis in terms which he is able to

7-22   understand. If it is not medically advisable to give this information to the

7-23   patient, the physician shall:

7-24    (a) Provide the information to an appropriate person responsible for the

7-25   patient; and

7-26    (b) Inform that person that he shall not disclose the information to the

7-27   patient.

7-28    6.  Receive from his physician the information necessary for him to

7-29   give his informed consent to a procedure or treatment. Except in an

7-30   emergency, this information must not be limited to a specific procedure or

7-31   treatment and must include:

7-32    (a) A description of the significant medical risks involved;

7-33    (b) Any information on alternatives to the treatment or procedure if he

7-34   requests that information;

7-35    (c) The name of the person responsible for the procedure or treatment;

7-36   and

7-37    (d) The costs likely to be incurred for the treatment or procedure and

7-38   any alternative treatment or procedure.

7-39    7.  Examine the bill for his care and receive an explanation of the bill,

7-40   whether or not he is personally responsible for payment of thGreen numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).e bill.

7-41    8.  Know the regulations of the facility or home concerning his conduct

7-42   at the facility or home.

7-43    9.  Receive, within reasonable restrictions as to time and place,

7-44   visitors of his choosing, including, without limitation, friends and

7-45   members of his family.

7-46    Sec. 12.  The amendatory provisions of this act do not apply to actions

7-47   taken before October 1, 2001.

7-48    Sec. 13.  The provisions of subsection 1 of NRS 354.599 do not apply

7-49   to any additional expenses of a local government that are related to the

7-50   provisions of this act.


8-1    Sec. 14.  1.  This section and sections 1 and 3 to 13, inclusive, of this

8-2  act become effective on October 1, 2001.

8-3    2. Section 2 of this act becomes effective at 12:01 a.m. on October 1,

8-4   2001.

 

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